Current principles of colorectal cancer screening - from opportunistic screening to a population-based screening program
Abstract
Colorectal cancer (CRC) is the second leading cause of death from malignancy all over the world. Annually, approximately 8,000 patients are newly diagnosed with this cancer and about 4,000 patients die because of this disease in the Czech Republic.
Due to the nature of the disease, it can be prevented by various screening methods. The National Czech CRC screening program has been running since 2000 and is focused on asymptomatic individuals aged over 50 years.
In 2014, the program began to send personal invitations to the CRC screening target population. The basic screening methods include the fecal occult blood test and colonoscopy.
While colonoscopy is considered to be the gold standard, compliance in asymptomatic individuals for this procedure is less than the recommended 50%. One reason for this might be the invasiveness of this examination.
Therefore, non-invasive fecal occult blood tests are used. New alternative screening methods are being sought that are less invasive with high sensitivity and adequate acceptance by the general population.
Such methods are DNA stool tests, sigmoidoscopy, computed tomography colonography, and capsule colonoscopy. In this article, CRC epidemiology, alternative screening examinations, and the results of the national CRC screening program (including personal invitations) are discussed.